Not Just Another Broken Heart: A Case Report of Takotsubo Cardiomyopathy Causing Syncope

TL;DR

This case report describes a rare heart condition causing fainting and highlights the importance of quick diagnosis using ultrasound.

Contribution

The paper presents a case of takotsubo cardiomyopathy with LVOT obstruction and emphasizes the role of point-of-care ultrasound in diagnosis.

Findings

A 66-year-old woman presented with syncope and ST-segment elevations, later diagnosed with takotsubo cardiomyopathy.

Point-of-care ultrasound identified apical hypokinesis and LVOT obstruction, aiding in rapid diagnosis.

LVOT obstruction in takotsubo cardiomyopathy is rare but linked to worse outcomes and requires early recognition.

Abstract

Patients with symptoms suggestive of acute coronary syndromes account for up to 10% of emergency department (ED) visits, and of those visits 2% are diagnosed with takotsubo syndrome. Takotsubo syndrome associated with left ventricular outflow tract (LVOT) obstruction is an important but uncommon cause of chest pain and syncope in patients presenting with ST-segment elevations. Although rare, this variant is associated with worse clinical outcomes. Early recognition of LVOT obstruction in these patients is important to help guide proper management.

We report a case of a 66-year-old female presenting to the ED after a syncopal episode with ST-segment elevations on the electrocardiogram. Point-of-care ultrasound revealed apical hypokinesis, thickened basal septum with LVOT obstruction and systolic anterior motion.

Point-of-care ultrasound can help quickly diagnose takotsubo cardiomyopathy and its complications, providing guidance to accurate management.

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